Perry County

Mental /Behavioral Health

Mental illness creates barrier for Newton's homeless

Newton Daily News - 11/22/2017

Nov. 22--Kelly Zach, a case manager at The Salvation Army, is often one of the first who meets the homeless in Newton. In early November, she assisted three new couples who identified as homeless, they came in seeking blankets, pop-top food and resources. Being without a place to live was a new experience for them.

Zach said the majority of people she works with have some type of mental illness. Her first step is encouraging them to connect with Jasper County's vast mental health resources such as Central Iowa Community Services and providers like Capstone, Optimae, House of Mercy and Integrated Treatment Services.

"There are just so many resources we can connect them to ... they can get three months of mental health treatment, and we can help with prescriptions if that's needed," Zach said. "The first priority is we want them to get to feeling better so they have the chance to get a job and get the money it's going to take to get into a place."

Zach sees a consistent number of homeless in the community, she said, working now with clients who have been homeless for a year or two.

"People don't want to realize we do have homelessness," Zach said. "The community thinks it's small scale. Nobody wants to say they are homeless."

Julie Smith, director at Capstone, said she sees the tie between mental health and homelessness in Newton.

"A lot of people we get in for therapy who report they are homeless are wanting help because they lost their job or their family has alienated them because of substance abuse issues or something like that."

She said finding affordable and livable housing can be a difficult obstacle to overcome, particularly when people with a past can't pass a background check to live in subsidized housing.

"I do think when they have a mental illness, it may be more difficult for them to navigate the system -- they don't have a place to live because they've burned their bridges in Newton," Smith said.

Connie Wright, director of Optimae LifeServices, said she agrees the issues with mental health and substance abuse are drivers for more complex situations in maintaining local housing.

"We see the inability to maintain where they're at and then background checks are impossible for some of them to clear," Wright said.

However, Optimae's services are crafted to help meet needs like maintaining safe, affordable housing. Those involved in its supported community living address those concerns.

"It's making sure paperwork gets completed, not losing subsidies, keeping it clean free of bugs or trash," Wright said. "If they are in our program, that's part of what I do. We've been able to keep people in apartments as long as they abide by the rules."

There are about 80 people who receive Optimae's home-based services, Wright said.

The local provider added a mental health care unit to its Newton building more than a year ago after seeing a demand for psychiatric services, medication and therapy.

Julie Bishop Gibson is the grant coordinator for a three-year grant which aims to increase access to mental health care and improve coordination among Jasper County providers like Capstone and Optimae.

When mental health was identified as the most critical health care concern across Jasper County, Skiff Medical Center and House of Mercy applied for $100,000 grant through the Catholic Health Initiatives. Gibson is in the second year of the grant work in which she's worked to build a strong collaboration among local providers.

The coalition meetings have gathered providers, law enforcement and others to tackle some tough conversations, Gibson said.

Gibson's goals, along with local stakeholders in the mental health coalition, include improving coordination among community organizations to provide coordinated mental health services and increasing the quality and quantity of outpatient mental health/substance abuse services.

"We have been able to identify roadblocks, bottlenecks and frustrations that restrict access to mental health care," Gibson said. "We identified a need for mobile crisis, support groups for families and individuals with mental health concerns, all of which are in place now or will be in the near future."

Gibson said the grant works to help the community understand the current mental health care environment with a reduced number of beds, Skiff's emergency department is often not able to be the solution to mental health crisis that it once was.

"By working with providers such as Capstone, House of Mercy, Optimae, Integrated Treatment Services, therapists or advanced nurse practitioners, to identify the right, quality mental healthcare solutions, citizens will be able to form healing relationships that lead to a greater sense of wellness for everyone involved," Gibson said.

Challenges for both Skiff Medical Center and local law enforcement who are required to be present during a mental health hold at its Emergency Room have remained steady since the closure of two state mental health hospitals.

Jasper County Sheriff John Halferty said it's not uncommon for his staff to spend more than 48 hours straight at Skiff because a patient is determined to need mental health care and no bed is available.

"It requires us to stay with the person constantly. It also takes a room at the emergency room and staff at the emergency room because they have their obligation to treat the patient as well," Halferty said.

Sonja Ranck, chief clinical officer at Skiff, said the average stay including wait time for a bed is 24-hours, but in some cases patients must wait multiple days.

"Statewide the same issues remain, with the significant lack of available beds for patients with mental health needs. When there is a delay in finding a bed, patients can experience long ED stays," Ranck said.

At the Jasper County Jail, 70 inmates were identified with a major mental illness this year, according to its latest report. Further, 59 inmates had mental health evaluations and 25 percent of inmates were on psychotropic drugs.

Halferty said mental health continues to be at the forefront of their duties at the Jasper County Sheriff's Office. His staff has been trained in mental health first aid, and they continue to offer more resources to those inmates who need help, he said.

"Without a doubt, we have had individuals and we currently have individuals who are in jail because either no (mental health) resources or facilities were available," Halferty said. "What happens many times is the individual is in a condition where they won't accept resources, and they end up committing a criminal act, misdemeanor crimes, and they end up in jail unable to bond out."

Outside of the jail, Halferty said much time is spent during mental health commitments and evaluations, transporting for evaluations and treatment and responding to calls for service for individuals in crisis.

"Many times our resources are exhausted due to the number of individuals who are suffering from mental health and/or substance abuse issues," Halferty said. "This affects our entire office from dispatchers handling mental health calls to our office staff handling the documentation."

Halferty said the mental health crisis needs to be addressed by a collective group of citizens and elected officials to push for legislation to help.

"Jail is not the easy answer for someone in crisis, but many times they end up there, due to a criminal charge," Halferty said.